A prospective study of Chlamydia trachomatis in first trimester abortion

Chlamydia trachomatis was isolated from 34 (17.9%) of 190 unselected women applying for first trimester abortion and from 27 (15.9%) of the 170 women who actually had the operation. C. trachomatis was more common among the younger women. Neisseria gonorrhoeae was isolated from 3 (1.6%) of 190 women. Culture positive patients and partners were given antibiotic treatment for 10 days, usually postoperatively. Early postoperative genital infection developed in 2 (7.4%) of the 27 chlamydia-positive and in 3 (2.0%) of the 143 chlamydia-negative women. There were no late infections. The antibiotic treatment significantly reduced the rate of postoperative pelvic inflammatory disease. At examination after 4-7 weeks all cultures were negative. Significantly more women with chlamydia-positive cultures were sero-positive preoperatively: with a microimmunofluorescence method, IgG titres greater than or equal to 1:160 were found in 74.1% of culture positive and in 47.6% of culture negative patients (p = 0.01). However, serological IgG screening does not identify individual high risk patients and so is of little clinical use in this context. We recommend preoperative screening for C. trachomatis in all women requesting an abortion and 10 days antibiotic treatment for all carriers.